{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T09:36:21Z","timestamp":1769160981432,"version":"3.49.0"},"reference-count":37,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"JSPS KAKENHI","award":["21K17227"],"award-info":[{"award-number":["21K17227"]}]},{"name":"Innovative Research Program on Suicide Countermeasures","award":["JPSCIRS20220305"],"award-info":[{"award-number":["JPSCIRS20220305"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The COVID-19 pandemic has profoundly affected impacted both physical and mental well-being. This matched cohort study investigated the effects of COVID-19 on pharmacological treatments for insomnia, using Japan\u2019s National Insurance Claims Database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were matched by age, sex, Charlson Comorbidity Index (CCI) score, and enrollment month. Incidence rate ratios (IRR) and incidence rate differences (IRD) were calculated and compared for insomnia medication initiation, and subgroups based on age and sex categories. Sensitivity analyses were conducted for segmented intervals of 0\u20134, 5\u201312, and after 12 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study included approximately 2 million pairs, predominantly women (59.4%), with a median follow-up of 7 months (Interquartile range, 4\u201312). Initiation of any insomnia medications occurred 77626 and 43142 times in the COVID-19 and control groups, respectively. IRR for new prescriptions was 1.7 times higher in the COVID-19 group (IRR: 1.71, 95% confidence interval [CI] 1.69\u20131.73), with an IRD of 1,634 events per 1,000,000 person-months (95%CI: 1599\u20131669). Non-Benzodiazepines and short-acting Benzodiazepines had the highest excess burdens among secondary endpoints. The risk was observed in all age categories, even in under 20 years (younger individuals: IRR: 1.46 95%CI 1.39\u20131.53, IRD: 380, 95%CI 333\u2013427). Sensitivity analysis confirmed an increased risk over time, even after 12 months (IRD: 752, 95%CI 662\u2013842).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>COVID-19 significantly associates with an elevated risk of insomnia medication initiation, emphasizing the necessity for mental health support in post-COVID-19 care. This study offers insights into the pandemic\u2019s influence on pharmacological treatment practices.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0341416","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T18:28:49Z","timestamp":1769106529000},"page":"e0341416","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of COVID-19 on new pharmacotherapy for insomnia: A matched cohort study using the national insurance claims database in Japan"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1352-3738","authenticated-orcid":true,"given":"Daisuke","family":"Miyamori","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuhei","family":"Yoshida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wataru","family":"Omori","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3401-8191","authenticated-orcid":true,"given":"Saori","family":"Kashima","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8218-9059","authenticated-orcid":true,"given":"Masanori","family":"Ito","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,1,22]]},"reference":[{"issue":"4","key":"pone.0341416.ref001","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1136\/jech-2021-216732","article-title":"Prescription of anxiolytics, sedatives, hypnotics and antidepressants in outpatient, universal care during the COVID-19 pandemic in Portugal: A nationwide, interrupted time-series approach","volume":"76","author":"M Estrela","year":"2022","journal-title":"J Epidemiol Community Health"},{"key":"pone.0341416.ref002","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.jpsychires.2021.09.054","article-title":"Onset and frequency of depression in post-COVID-19 syndrome: A systematic review","volume":"144","author":"O Renaud-Charest","year":"2021","journal-title":"J Psychiatr Res"},{"issue":"1","key":"pone.0341416.ref003","doi-asserted-by":"crossref","first-page":"100196","DOI":"10.1016\/j.ijchp.2020.07.007","article-title":"Prevalence of depression during the COVID-19 outbreak: A meta-analysis of community-based studies","volume":"21","author":"J Bueno-Notivol","year":"2021","journal-title":"Int J Clin Health Psychol"},{"issue":"1","key":"pone.0341416.ref004","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1038\/s41398-024-02894-z","article-title":"Utilization of antidepressants, anxiolytics, and hypnotics during the COVID-19 pandemic","volume":"14","author":"M Tiger","year":"2024","journal-title":"Transl Psychiatry"},{"issue":"3","key":"pone.0341416.ref005","doi-asserted-by":"crossref","DOI":"10.1084\/jem.20202135","article-title":"Neuroinvasion of SARS-CoV-2 in human and mouse brain","volume":"218","author":"E Song","year":"2021","journal-title":"J Exp Med"},{"key":"pone.0341416.ref006","doi-asserted-by":"crossref","DOI":"10.1093\/sleep\/zsac079.677","article-title":"0681 Association of poor sleep with stress, anxiety, emotional support, social isolation, and depression during the COVID-19 pandemic","volume":"45","author":"T Teague","year":"2022","journal-title":"Sleep"},{"key":"pone.0341416.ref007","article-title":"Persistent symptoms among post-COVID-19 survivors: A systematic review and meta-analysis","author":"E Rochmawati","year":"2022","journal-title":"J Clin Nurs"},{"issue":"4","key":"pone.0341416.ref008","doi-asserted-by":"crossref","DOI":"10.1016\/S1473-3099(21)00703-9","article-title":"WHO Clinical Case Definition Working Group on Post-COVID-19 Condition. A clinical case definition of post-COVID-19 condition by a Delphi consensus","volume":"22","author":"JB Soriano","year":"2022","journal-title":"Lancet Infect Dis"},{"issue":"1","key":"pone.0341416.ref009","doi-asserted-by":"crossref","first-page":"1957","DOI":"10.1038\/s41467-022-29521-z","article-title":"Persistent COVID-19 symptoms in a community study of 606,434 people in England","volume":"13","author":"M Whitaker","year":"2022","journal-title":"Nat Commun"},{"issue":"1","key":"pone.0341416.ref010","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1186\/s12879-022-07062-6","article-title":"Post-acute COVID-19 syndrome in patients after 12 months from COVID-19 infection in Korea","volume":"22","author":"Y Kim","year":"2022","journal-title":"BMC Infect Dis"},{"key":"pone.0341416.ref011","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.jpsychires.2021.11.031","article-title":"One-year mental health outcomes in a cohort of COVID-19 survivors","volume":"145","author":"MG Mazza","year":"2022","journal-title":"J Psychiatr Res"},{"issue":"1","key":"pone.0341416.ref012","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1038\/s41380-022-01614-7","article-title":"A systematic review and meta-analysis of long term physical and mental sequelae of COVID-19 pandemic: Call for research priority and action","volume":"28","author":"N Zeng","year":"2023","journal-title":"Mol Psychiatry"},{"key":"pone.0341416.ref013","doi-asserted-by":"crossref","first-page":"1168100","DOI":"10.3389\/fpsyt.2023.1168100","article-title":"Treatment strategy for insomnia disorder: Japanese expert consensus","volume":"14","author":"Y Takaesu","year":"2023","journal-title":"Front Psychiatry"},{"issue":"5","key":"pone.0341416.ref014","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2019-033365","article-title":"How was cognitive behavioural therapy for mood disorder implemented in Japan? A retrospective observational study using the nationwide claims database from FY2010 to FY2015","volume":"10","author":"Y Hayashi","year":"2020","journal-title":"BMJ Open"},{"issue":"3","key":"pone.0341416.ref015","article-title":"Acute and delayed psychiatric sequelae among patients hospitalised with COVID-19: A cohort study using LIFE study data","volume":"35","author":"F Murata","year":"2022","journal-title":"Gen Psychiatr"},{"issue":"2","key":"pone.0341416.ref016","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.jsmc.2022.02.008","article-title":"The effects of insomnia and sleep loss on cardiovascular disease","volume":"17","author":"MS Khan","year":"2022","journal-title":"Sleep Med Clin"},{"key":"pone.0341416.ref017","doi-asserted-by":"crossref","first-page":"101215","DOI":"10.1016\/j.smrv.2019.101215","article-title":"Insomnia and risk of mortality from all-cause, cardiovascular disease, and cancer: Systematic review and meta-analysis of prospective cohort studies","volume":"48","author":"L Ge","year":"2019","journal-title":"Sleep Med Rev"},{"key":"pone.0341416.ref018","article-title":"The economic burden of insomnia: Direct and indirect costs for individuals with insomnia syndrome, insomnia symptoms, and good sleepers","year":"2009","journal-title":"Sleep"},{"key":"pone.0341416.ref019","unstructured":"Minisitry of Health Labour and Welfare. Database on regional disparities in medical expenditure (Iryohi map). 2023. https:\/\/www.mhlw.go.jp\/content\/iryohi_r04_kiso.xlsx"},{"key":"pone.0341416.ref020","unstructured":"Ministry of Health Labour and Welfare. Response to COVID-19 after the classification change. 2023. https:\/\/www.mhlw.go.jp\/stf\/seisakunitsuite\/bunya\/0000164708_00079.html"},{"issue":"5","key":"pone.0341416.ref021","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation","volume":"40","author":"ME Charlson","year":"1987","journal-title":"J Chronic Dis"},{"issue":"11","key":"pone.0341416.ref022","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1097\/01.mlr.0000182534.19832.83","article-title":"Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data","volume":"43","author":"H Quan","year":"2005","journal-title":"Med Care"},{"issue":"5","key":"pone.0341416.ref023","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1016\/S2215-0366(21)00084-5","article-title":"6-month neurological and psychiatric outcomes in 236\u2009379 survivors of COVID-19: A retrospective cohort study using electronic health records","volume":"8","author":"M Taquet","year":"2021","journal-title":"Lancet Psychiatry"},{"issue":"1","key":"pone.0341416.ref024","first-page":"9","article-title":"Long-term Effects of COVID-19 on Sleep Patterns","volume":"26","author":"S Batool-Anwar","year":"2025","journal-title":"Thorac Res Pract"},{"key":"pone.0341416.ref025","doi-asserted-by":"crossref","first-page":"101895","DOI":"10.1016\/j.cpr.2020.101895","article-title":"Sleep and suicide: A systematic review and meta-analysis of longitudinal studies","volume":"81","author":"RT Liu","year":"2020","journal-title":"Clin Psychol Rev"},{"issue":"6","key":"pone.0341416.ref026","doi-asserted-by":"crossref","first-page":"2438","DOI":"10.3390\/jcm12062438","article-title":"The Associations between Insomnia Severity and Health Outcomes in the United States","volume":"12","author":"F-X Chalet","year":"2023","journal-title":"J Clin Med"},{"issue":"6","key":"pone.0341416.ref027","doi-asserted-by":"crossref","DOI":"10.1016\/j.jinf.2020.08.029","article-title":"Post-discharge persistent symptoms and health-related quality of life after hospitalization for COVID-19","volume":"81","author":"E Garrigues","year":"2020","journal-title":"J Infect"},{"issue":"4","key":"pone.0341416.ref028","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1080\/13854046.2022.2030412","article-title":"Outcomes in post-acute sequelae of COVID-19 (PASC) at 6 months post-infection Part 1: Cognitive functioning","volume":"36","author":"DM Whiteside","year":"2022","journal-title":"Clin Neuropsychol"},{"key":"pone.0341416.ref029","doi-asserted-by":"crossref","DOI":"10.7554\/eLife.86014","article-title":"Immune mechanisms underlying COVID-19 pathology and post-acute sequelae of SARS-CoV-2 infection (PASC)","volume":"12","author":"S Mohandas","year":"2023","journal-title":"Elife"},{"key":"pone.0341416.ref030","doi-asserted-by":"crossref","first-page":"100460","DOI":"10.1016\/j.bbih.2022.100460","article-title":"The unique contribution of depression to cognitive impairment in Post-Acute Sequelae of SARS-CoV-2 infection","volume":"22","author":"LA Brown","year":"2022","journal-title":"Brain Behav Immun Health"},{"issue":"5","key":"pone.0341416.ref031","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1056\/NEJMc2033369","article-title":"Microvascular Injury in the Brains of Patients with Covid-19","volume":"384","author":"M-H Lee","year":"2021","journal-title":"N Engl J Med"},{"key":"pone.0341416.ref032","first-page":"123","article-title":"Productivity of working from home during the COVID-19 pandemic: Evidence from an employee survey","volume":"49","author":"M Morikawa","year":"2020","journal-title":"Covid 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